Open Access Highly Accessed Research article

Patterns of Long Term Care in 29 European countries: evidence from an exploratory study

Gianfranco Damiani1*, Valentina Farelli1, Angela Anselmi1, Lorella Sicuro1, Alessandro Solipaca2, Alessandra Burgio2, Domenica Fioredistella Iezzi3 and Walter Ricciardi1

Author Affiliations

1 Department of Public Health, Università Cattolica del Sacro Cuore - Rome, Italy

2 Health and Assistance Unit, Italian National Institute of Statistics, ISTAT - Rome, Italy

3 Social Statistics, Università di Tor Vergata - Rome, Italy

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BMC Health Services Research 2011, 11:316  doi:10.1186/1472-6963-11-316

Published: 18 November 2011

Abstract

Background

The challenges posed by the rapidly ageing population, and the increased preponderance of disabled people in this group, coupled with the rising level of public expenditure required to service the complex organization of long term care (LTC) delivery are causing increased pressure on LTC systems in Europe. A pan-European survey was carried out to evaluate whether patterns of LTC can be identified across Europe and what are the trends of the countries along them.

Methods

An ecological study was conducted on the 27 EU Member States plus Norway and Iceland, referring to the period 2003-2007. Several variables related to organizational features, elderly needs and expenditure were drawn from OECD Health Data and the Eurostat Statistics database and combined using Multiple Factor Analysis (MFA).

Results

Two global Principal Components were taken into consideration given that their expressed total variance was greater than 60%. They were interpreted according to the higher (more than 0.5) positive or negative correlation coefficients between them and the original variables; thus patterns of LTC were identified. High alignment between old age related expenditure and elderly needs characterizes Nordic and Western European countries, the former also having a higher level of formal care than the latter. Mediterranean as well as Central and South Eastern European countries show lower alignment between old age related expenditure and elderly needs, coupled with a level of provision of formal care that is around or slightly above the average European level. In the dynamic comparison, linear, stable or unclear trends were shown for the studied countries.

Conclusions

The analysis carried out is an explorative and descriptive study, which is an attempt to reveal patterns and trends of LTC in Europe, allowing comparisons between countries. It also stimulates further researches with lower aggregated data useful to gain meaningful policy-making evidence.

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